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1245511765
GEN TANAKA
BROCKTON, MA
NPI
1245511765
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
(Licence: MA 248497)
Enumeration Date
2011-08-30
Last Update Date
2011-08-30
Business Address
-- GEN TANAKA M.D.
940 BELMONT ST PSYCHIATRY 116A7
BROCKTON, MA 02301-5596
Phone number: 774-826-2458
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Mailing Address
-- GEN TANAKA M.D.
75 DONALD ST APT 58
WEYMOUTH, MA 02188-3962
Phone number: 310-793-6152
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